Læknablaðið : fylgirit - 01.05.1978, Page 17

Heinola Study Group^) FOLLOW-UP SURVEY OF
ARTHRITIS, HEINOLA
In 1971, on Prof. Veikko Laine’s initiative,
planning of a long-term research program for
the Rheumatism Foundation Hospital was started.
Because of practical reasons a clinical follow-up
survey was chosen. The project started in 1973,
and the sampling of the patient material lasted
two years. In this paper some basic features of
the survey will be presented.
The study is financially supported by the Finnish
Academy of Sciences and the Social Insurance
Institution of Finland.
The main goals of this interdisciplinary project
are definitions of prognostically important medical,
social and psychological signs, diagnostic criteria
at the early stage of the inflammatory joint
disease, etiological factors of the arthritis as well
as the benefits and costs of the treatment.
The area from which we get our patients for
the study includes five towns and the surrounding
countryside. The population of this area is
360.000.
All physicians working in the area are informed
many times by letters and announcements. They
are asked to send to our hospital patients who
fulfil the following criteria:
1. age 16 years or more
2. swelling of at least one joint
3. joint swelling has not lasted more than six
months
Our hospital collects the patients, makes
clinical, radiological and routine laboratory
examinations, takes blood and tissue samples and
sends them to research laboratories for analysis.
All data is treated in a form suitable for com-
puters. Altogether we co-operate with seven
institutes, and the whole group includes 26
scientists.
x) Isomáki H, Ahlqvist J, Aho K. Ahvonen P,
v. Essen R, Jansson E, Kajander A, Kiviniemi
P, Koota K, Laine V, Larsen A, Laurinkari
J, Martio J, Makisara G-L, Makisara P,
Nissila M, Nuotio P, Penttinen K, Raunio J,
Raunio P, Rimon R, Rasánen J, Sarna S,
Tiilikainen A, Wager O, Vainio K.
RESULTS
During two years we received totally 446 patients.
In addition, 11 patients have been accepted later,
so that total patient material includes 457 arthritie
patients, whose disease has not lasted more than
six months when first seen in our hospital.
The incidence of arthritis was about 1 %o in a
year in population over 16 years. This is far to
low. We have studied the situation more precisely
in Heinola. Dr. Juha Raunio obtained an incidence
of-2.1%o in Heinola in 1974. Also this incidence
probably is too low. It seems almost impossible
to get the true incidence of beginning arthritis by a
passive sampling method.
The first diagnosis, which doesn’t mean the
final diagnosis in chronic cases, was probable
RA in 147o, definite RA in 33% (together 47%),
ankylosing spondylitis only in 47o because of the
criteria for the study which required swelling of
a joint, Reiter’s disease in 9%, reactive post-
infectious arthritis in 8%, non defined arthritis
(mostly of one knee joint) in 197o, 11 patients
with psoriatic arthritis, 1 patient with rheumatic
fever, 7 patients with gouty arthritis, 6 patients
with osteoarthritic joint swelling, 5 patients with
acute sarcoidosis, 8 patients with systemic
connective tissue disease, and 28 patients with
other joint diseases. The low frequency of
rheumatic fever and the high frequency of non
defined arthritis are remarkable.
The sex distribution shows that females dominate
especially in RA. Only in the disease-group of
ankylosing spondylitis, Reiter’s disease and
reactive postinfectious arthritis ("HLA B 27
disease") females are in minority.
The clinical picture of the arthritis in younger ,
age-groups was not so often rheumatoid arthritis
than in the eldest age group, where 73 per cent
of all patients were first classified as rheumatoid
arthritis and only 1 female patient as reactive
postinfectious arthritis.
The HL-A antigens have been typed in 272
patients. The frequency of the HLA B 27 was 30%
in RA, 83% in ankylosing spondylitis, 66% in
Reiter’s disease, 89% in reactive postinfectious
arthritis, 29% in psoriatic arthritis, 38% in non
defined arthritis, 18% in other joint diseases
15